AUSTIN — The enormous state agency that runs Texas’ Medicaid program, foster-care system and many other services is “fragmented,” insufficiently reliant on data and suffering from poor management in its internal regulation division, according to a scathing, once-a-decade report released Friday.

The state Sunset Advisory Commission staff report recommended that the five departments that make up the Health and Human Services Commission consolidate into one agency, a dramatic move that would continue a trend in an area of state government that as recently as 2002 included 12 agencies.

“The current system structure also aggravates fragmentation of client services, resulting in divided policy direction and administrative oversight, difficulty for customers to know where to go for services, duplicated administrative services, and unnecessary expenses,” according to the 225-page report, which particularly criticized the commission’s “uncoordinated approach” to websites, hotlines, data management, women’s health programs and the Medicaid enrollment process.

The report saved its harshest language for the commission’s Office of Inspector General, however, saying that division has a difficult job but uses “inefficient and ineffective processes” that along “with other issues such as poor communication and transparency, limited staff training, and a lack of performance data from a case management system, point to limited oversight and the need for further review.”

The staff report is non-binding but will form the basis of a report to be finalized this fall by the official Texas Sunset Commission. The commission evaluates each state agency once a decade and issues recommendations that the full Legislature must approve, modify or allow the agency to be abolished.

The head of the commission said in a statement that he appreciates the work done by the Sunset Commission staff to produce the report.

“I’m working closely with the commissioners of our agencies to look for ways we can simplify things behind the scenes so it’s easier for people to get the help they need no matter which of our agencies they turn to first,” said the executive commissioner, Kyle Janek. “Whatever the Legislature ultimately decides, we’ll be ready to quickly put in place the changes they approve to improve our programs and ensure we operate as efficiently as possible.”